Insight and Information

[sstoots]

A little background..... I have been on the forum and I've done some research on total knee arthoplasty . I have seen one orthopedic (four months ago) and concluded that my left knee required TKR. He said I shouldn't wait long as it could accelerate the demise of my right knee (which is bad and getting worse). I have had three scopes done (one on the left and two on the right) several decades ago. My left knee is much worse now and getting worse by the week. I have an appointment to see a second doctor (one of the best in the area), but not until May 14. Seems a foregone conclusion that the left will need a TKR and I am hoping that I am a candidate for MIS. What would rule out my eligibility for MIS? When I had my knees scoped, the surgeon said the operation took longer than normal because 'it was so tight in there'. Is that an indication that I might not be a good MIS candidate?

 

[ship4]

Hi, and Welcome! to the forum....
Rather than be concerned about MIS, I would be concerned about finding a competent OS who does TKR on a regular basis and does it well......
This is the way I pursued my BTKR. I found a good OS with an excellent reputation. I scheduled with him 6 months out and had a wonderful outcome.
MIS is not all that it is cracked up to be if you have an OS who does not often do TKR............ JMO
You will find an OS you are comfortable with and eventually have your TKR done. For me, the sooner the better as both my knees were bad, but I still had full ROM at the time of surgery. Good Luck with your second opinion.
Best,
Crystal

 

[Judles]

Crystal raises some excellent points! Good
Luck with your second opinion! Let us
Know how everything goes......and welcome
To Bonesmart!!!!

 

[Josephine]

Minimally Invasive Surgery - can you define for me exactly what you think that means? Then I can give you a more direct answer ...

 

[sstoots]

I understand MIS to be quad (muscle) sparing surgery. Smaller incision, easier
recovery, out of the hospital sooner, and generally a return to normalcy sooner than the traditional procedure. Is this procedure an option for TKR or is it only valid for partial knee replacement? Does the type (manufacturer) of implant influence this? Yes, I understand that the emphasis should be on finding the best surgeon to replace the knee regardless of procedure, but all things being equal, if a given suregeon has done hundreds/thousands of each, and I am a candidate for MIS, why wouldn't I want a MIS procedure?

 

[Jamie]

Hi, Sstoots....I'm going to let our forum nurse, Josephine, respond to your questions. But I wanted to welcome you to BoneSmart and tell you we're glad you decided to join the forum.

Good luck with your knee surgery! We'll be here to provide whatever support you might need.

 

[Oldmancrash]

sstoots, good question. I had not thought about not being able to have MIS if the OS performs it. Hummmm more questions to write down to ask the OS

 

[Simon]

SSToots

The sentence about it being tight in there hit me as I had several previous surgeries and when I had the BTKR the right knee (the worse one) was so tight that they could not even follow the standard procedure of flipping the patella up to get it out of the way. They had to really work at it to get it off to the side. Just something to think about. Computer assisted surgery is one way to reduce some of the surgery time and cutting. My OS used the computer and it still took 3 times longer than planned. Just something to follow up with.

Simon

 

[Bennet]

Sstoots,

I think that your thinking is appropriate. If you can find a competent OS, who you like, who has extensive experience with MIS, and who indicates that they are comfortable performing your surgery, then I think you should seriously consider them as an option. I had MIS BTKR in December and have had excellent results. What you've heard about the recovery process is consistent with my personal experience as well as the feedback I've received from professionals as well as others who had traditional surgery.

So good luck with your second opinion. It is so important to do your research and find a competent surgeon. I've met a number of people who didn't and were very dissatisfied with their outcome. As everyone on this list could attest, this IS a BIG deal procedure.

Best of luck,

Bennet

 

[Sandy R]

You might want to go to the MIS section of Bonesmart. Some of us that have had a TKR quad-sparing MIS surgery, have posted our experiences... for the most part, if not all, positive. My OS does hundreds of total and partial quad-sparing TKR's every year. I would certainly want to go with an OS that is proficient in this type surgery... being a guinea pig doesn't make sense. My experience was with a total TKR: Monday morning a 2 hour surgery, up walking that afternoon with a walker, on crutches that evening. Tuesday morning, walked with a cane, that afternoon walked without any aid. Wednesday morning, OS came in and asked me if I wanted to go home... I was discharged at noon. Over the next several weeks, it wasn't a picnic, it's major surgery! BTW, I'm turning 70 next month... and now 6 months post-op and feel great. Good luck to you, whichever way you go...
Sandy

 

[Josephine]

Good answer, sstoots. Just wanted to make sure you weren't expecting too much!

Candidates for MIS generally need to be of average weight for their height (i.e. not overweight!) and to have not had too much in the way of previous surgeries. Each surgery you have creates scar tissue which can make it 'tight'. However, in my experience, most surgeons try to use as small an incision as they can get away with and quads sparing can be included in a 'traditional' incision as well as MIS.